Organization Active NPI

William C. Gimness, O.D., P.S.

  • Optometrist
  • Chewelah, WA
National Provider Identifier
1871650648
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001225 Issued in WA
Legal business name
WILLIAM C. GIMNESS, O.D., P.S.
Practice address
306 N. Park St
Chewelah, WA 99109
Phone
(509) 935-2020
Fax
(509) 935-6795
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. William Charles Gimness, O.D.
Title
Director
Phone
(509) 935-2020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OD00001225 WA Primary
Durable Medical Equipment & Medical Supplies 332B00000X OD00001225 WA

Addresses

Primary practice location

306 N. Park St
Chewelah, WA 99109

Mailing address

PO Box 836
Chewelah, WA 99109-0836
Phone (509) 935-2020

Other identifiers 2

IdentifierTypeStateIssuer
2035269MedicaidWA
DB5537OtherWARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

147 N Clark St
Republic, WA 99166
Phone (509) 775-3075

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1871650648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 836",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991090836",
            "telephone_number": "509-935-2020",
            "fax_number": "509-935-6795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N. PARK ST",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "99109",
            "telephone_number": "509-935-2020",
            "fax_number": "509-935-6795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM C. GIMNESS, O.D., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "GIMNESS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "509-935-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001225",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "OD00001225",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2035269",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB5537",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chewelah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.